Cold caps show promise in keeping hair through chemo

Cooling caps

Handout

Handout

Danielle Braff, Special to Tribune Newspapers

People with cancer who are undergoing chemotherapy may soon be able to check one side effect off of their list: hair loss. If the claims and study results are as good as they appear to be, patients can wear a cold hat during chemotherapy to prevent their hair from falling out.

The claim

A cooling cap — marketed under the brand names DigniCap and Penguin Cold Cap — is tightly attached to your head during chemotherapy treatment and sends consistent cooling to all areas of your scalp. The temperature of the cap is about 40 degrees Fahrenheit, which is uncomfortable and may cause headaches, but the side effects are temporary.

Because your body temperature will warm up the cap quickly, you may need to replace the cooling caps more than 15 times through one treatment. That depends on the cap — the DigniCap doesn't require changing; the Penguin Cold Cap does. Both caps lower the temperature of your scalp, making the surrounding blood vessels contract. The contractions result in a significant reduction of cytotoxins reaching your hair follicles.

Translation: When your scalp is kept at that constant cold temperature during chemotherapy treatments, your hair follicles will absorb fewer of the chemotherapy chemicals that lead to hair loss.

The reality

A 2010 study by researchers in Finland looked at 64 patients who used the caps. Hair loss was avoided in differing amounts by all of the patients, and only 20 percent of them decided to wear a wig following the treatment, the study found.

And a 2003 study at University Hospital in Sweden examined 74 women with breast cancer, endometrial cancer, Hodgkin lymphoma or sarcoma who used the cap. They found that two patients stopped using the cap because it was uncomfortable, but 72 patients saw prevention of hair loss. Neither study was paid for by the cap-makers, though the caps, in some cases, were donated by the company.

Though the FDA hasn't given its stamp of approval yet, it did allow an investigational study in the U.S. looking at 20 women with breast cancer.

The study was just finished, and the data is being analyzed by the researchers before the results will be released, said Dr. Susan Melin, principal investigator for the study and associate professor of oncology at Wake Forest Baptist Medical Center.

"We don't yet have results, but feedback from some of our patients was generally positive," Melin said. "The cold cap works by decreasing blood flow to the hair follicles and by decreasing the hair follicles' metabolism, which then decreases exposure to the chemotherapy."

So far, the caps have been used by about 4,000 people since the product's launch about 20 years ago in Sweden, and though some doctors have voiced their concern about whether the caps may reduce the effectiveness of the chemotherapy, no problems have yet been reported.

Will they be available here?

The caps won't be available in the U.S. unless they are approved by the FDA, at which time the cost and any insurance coverage will be determined. And though they're only being tested here for use in those with breast cancer, the makers of the caps said they can be eventually used for patients with all kinds of cancer.